Decompression sickness in the Singapore Mass Rapid Transit Project

Area of Science:

• Occupational Health
• Tunneling Engineering
• Hyperbaric Medicine

Background:

• The Singapore Mass Rapid Transit (MRT) project involved extensive underground tunneling using compressed air.
• 1,737 compressed air workers (CAWs) were employed, undergoing significant decompression procedures.

Purpose of the Study:

• To report the incidence and clinical presentation of decompression sickness (DCS) in CAWs.
• To identify factors contributing to the low DCS incidence and discuss prevention strategies.

Main Methods:

• Retrospective analysis of decompression records and DCS cases among CAWs.
• Review of clinical presentations and treatment outcomes for DCS.

Main Results:

• An overall DCS incidence of 0.087% was recorded (160 Type I, 4 Type II cases).
• Strict medical selection, adherence to decompression protocols, and acclimatization were key factors in the low incidence.
• Prompt treatment led to a low relapse rate.

Conclusions:

• The Singapore MRT project demonstrated that rigorous safety protocols can significantly minimize DCS in compressed air workers.
• Continuous monitoring of worksite environment and practices is crucial for DCS prevention.